This weekend, I ventured out with the Street Med outreach team. Our team provides weekly healthcare to some unhoused populations in downtown St Louis. We come bearing donations of food, clothing and hygiene products, but mainly we lug around big red doctor bags and address medical concerns. While one member of the team was tending to a wound on a young man’s arm, I found myself speaking with his partner. The couple sat on collapsible outdoor chairs parked outside of the tent where they reside together. She was tearful and her face carried more wrinkles than would be expected for her age. Her thoughts were flooded with uncertainty, as she considered the idea of going to a treatment program.
“We’ve been here for over a year, you know. We have people here.”
Community comes in all different shapes and sizes, I realized. It was strong here, among folks who, for varied reasons, are not living in conventional housing situations. My unhoused friend was fearful of the unknown, and hesitant to leave behind a place that she had become familiar with. Her tears literally hit the floor as she talked. The decision felt overwhelming. I crouched down near her and listened, validated.
I’m not sure if it was the tears dripping from her cheeks or just a general feeling in the air, but I noticed myself feeling a little lost. (I’m a psychiatrist, so I try to pay attention to feelings, and do my best to name those feelings.) I considered behavioral techniques that help connect back to the present. Grounding oneself through use of the five senses is an example of a mindfulness strategy, which has been shown through much research, to help with mental health conditions. It is beautifully simple. You focus on each of your five senses and pay attention to what is going on around you, which can distract from anxious or overwhelming thoughts. I reflected on our Street Med outreach day and thought of things that hit each of my senses.
Sight– I saw the birds flying through blue skies while the Mississippi River was steadily rolling by. It was serene to take in all that blue.
Sound – A loud freight train passed above us for several minutes. Our medicine team kept talking through the noise as we walked to our destination. When we arrived, we found a fence, put in place by a city mandate I guess, and all of the previous residents of the encampment area were gone.
Smell – There was a fire burning in one of the areas, and an unhoused friend led us away from it as we started opening up our bags to distribute supplies. “I don’t want y’all to have to breathe this in.”
Taste – My own dry mouth.
Touch – I received a hug from an unhoused woman I had met with two or three times before. She makes poor eye contact, perhaps is paranoid, and yet she delivered a kind, respectful and grateful hug.
Focusing on my five senses not only helped me feel grounded, but it reminded me of all the things that make the work being done by Street Med STL so important.
Naazia Azhar, MD
*Some details related to patient stories may be altered to protect the privacy of those we serve.